Step 3 Predictor: Forecast Your USMLE Step 3 Score
Step 3 is the final hurdle — and the only one with CCS computer-based case simulations. Drop in your UWSA Step 3 and Free 120 numbers to get a pass probability and a Step 2 CK-comparable estimate.
Two-day exam
Day 1: 232 MCQs over 7 hours. Day 2: 180 MCQs + 13 CCS cases (computer-based patient simulations). Most candidates split Days 1 and 2 with 1-2 days off.
When most residents take it
Roughly 70% take Step 3 between PGY-1 and PGY-2. Specialties requiring an H1B visa often push for completion before residency starts.
What employers care about
Step 3 is mostly pass/fail in importance. Fellowship programs glance at the score for borderline candidates, but most weight is on Step 2 CK.
Run the Step 3 calculator
Pick Step 3 below, then enter your UWSA Step 3 and Free 120 scores. The calculator outputs a three-digit prediction with a 95% confidence interval.
Note: Step 3 data is sparser than Step 2 CK. Confidence intervals run wider (±6-8 pts) until you provide 3+ inputs.
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Step 3 pass-probability bands
Bands below assume MCQ-side prediction (CCS not yet graded). CCS typically adds or subtracts up to 5 points depending on performance.
The CCS portion: where most candidates lose points
CCS is the unique part of Step 3 — 13 computer-based patient simulations where you order labs, treatments, and follow-ups in simulated time. Most residents have never practiced this kind of interface before. Here is what matters.
1. Order what you would actually order. The CCS software rewards appropriate workup, not exhaustive workup. Do not shotgun every imaging modality.
2. Advance the clock correctly. A common pitfall: ordering CT in 2 minutes when biologically it takes 30 minutes to result. Use realistic time advances.
3. Move the patient to the right setting. If a ward patient becomes unstable, transfer to ICU. If a stable outpatient walks in, do not admit. Setting transitions are graded.
4. Practice with UWorld CCS. 50 cases minimum. You should be able to hit the "5 must-do orders" on a standard MI workup without thinking.
5. Watch the clock on Day 2. You get ~10-20 minutes per case. Move steadily — incomplete cases hurt more than imperfect ones.
Step 3 predictor FAQs
What is the Step 3 passing score?+
198. It is the lowest of the three Step exams and the most pass/fail-feeling in stakes for most US graduates.
Is Step 3 harder than Step 2 CK?+
Different. The MCQs are slightly easier per question, but the test is longer (two days, 9 hours of MCQs + CCS) and tests management decisions you have not made before. Most people score 5-15 points lower than their Step 2 CK.
How is CCS scored?+
CCS is graded on a clinical-decision rubric: appropriate workup, correct sequencing, monitoring intervals, avoiding harm. The score gets folded into your composite Step 3 result. Roughly 20-25% of the total Step 3 score comes from CCS.
Which practice resources are predictive?+
UWSA Step 3 (most predictive), Free 120 Step 3, AMBOSS Step 3, and the NBME Comprehensive Basic Science / Clinical Science self-assessments. NBME Step 3 forms exist (CCSE) but are less granular.
When should I take Step 3?+
If your program does not pressure you, take it between intern year and PGY-2 (June-August). You have UWorld momentum, you've seen ward management decisions live, and PGY-2 brings more responsibility.
Take the guesswork out of Step 3
Free, instant, and built on Step 3 specifically — not just a Step 2 CK calculator with a different label.